title: Peritumoural vascular invasion: a major determinant of triple-negative breast cancer outcome.
abstract: OBJECTIVE
  Triple-negative breast cancers (TNBC) have the worst outcome of all breast cancer subtypes. Nevertheless TNBC are heterogeneous in terms of pathological, biological and prognostic behaviours. We explored clinical and pathological factors correlated with outcome in this phenotype.
  
  
  METHODS
  We retrospectively studied clinical and pathological factors correlated with prognosis in a series of 344 early TNBC. Staining for blood (CD31) and lymphatic (Podoplanin) vascular endothelium markers was performed to best characterise peritumoural vascular invasion (PVI) in 108 cases available for pathological reviewing.
  
  
  RESULTS
  Univariate and multivariate analyses performed on our whole cohort underlined PVI as an independent predictive factor of distant metastasis (p=0.00012, HR=2.72 [1.63-4.52]). Standardised pathological reviewing of 101 histologically confirmed TNBC showed that PVI, observed in 41% (28% by haematoxylin and eosin staining plus 13% by immunohistochemistry), was confirmed as the first prognostic factor in TNBC, particularly in node-negative tumours. Five-year metastasis-free survival in this subset was 87.5% and 50.8% without and with PVI, respectively (p=0.003).
  
  
  CONCLUSIONS
  Vascular invasion diagnosis is improved by the combination of HES and IHC. Moreover it is a major prognostic feature and must take a greater part in therapeutic management of early TNBC with the possibility to adapt the adjuvant treatment according to the predicted relapse risk.
authors.affiliation: Molecular Oncology Department, Centre de Recherche en Cancérologie de Marseille, UMR891 Inserm, Institut Paoli-Calmettes, Marseille, France. sabatierr@marseille.fnclcc.fr
authors.forename: Renaud
authors.initials: R
authors.lastname: Sabatier
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Jacquemier
authors.forename: François
authors.initials: F
authors.lastname: Bertucci
authors.forename: Benjamin
authors.initials: B
authors.lastname: Esterni
authors.forename: Pascal
authors.initials: P
authors.lastname: Finetti
authors.forename: Francine
authors.initials: F
authors.lastname: Azario
authors.forename: Daniel
authors.initials: D
authors.lastname: Birnbaum
authors.forename: Patrice
authors.initials: P
authors.lastname: Viens
authors.forename: Anthony
authors.initials: A
authors.lastname: Gonçalves
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Extra
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000098:blood supply* / Q000473:pathology*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone